Pro-vaccine forces need to demonstrate more respect and less derision when dealing with anti-vaccine forces and realize that it is not enough, and is likely counter-productive, for them to just stamp their feet and insist the science is settled and dissenters should be made to comply. If an anti-vaccine person has an objection, that objection should be addressed politely and thoroughly and not simply dismissed with a hand wave and condescension.

This does not mean therefore that there should be no information campaigns, no attempts to inform people that their health should be better if they stagger up off the couch for a walk for 30 minutes a day. That’s all just fine. But what it does mean is that none of these campaigns or actions can be justified by reference to the costs to the welfare state or the public purse. It just ain’t true that fatty, puffing boozers impose costs upon said welfare state: thus reducing the number of fatty, puffing boozers isn’t going to save that welfare state any money.

The power of placebos to heal has long been recognized. Thomas Jefferson wrote about it. So did Benjamin Franklin. Debate over the ethics of placebos also has a long history—roughly 170 years. But there has been no resolution. Doctors are still in disagreement about whether it is ethical to proscribe a placebo without the patient’s consent. Of course if the patient knows the therapy is a placebo, much of its effectiveness is lost. But there is also disagreement about the meaning of the word “consent.”

In reading critics of Obamacare, I occasionally come across an interesting, if mildly paranoid, theory—that it was designed to fail in order to bring in the single payer system that its supporters really wanted. I would not be surprised if there were supporters who saw it that way, but I doubt that they represented a significant fraction of those that initially supported the program. It is, however, worth thinking about whether that strategy, deliberate or not, will work. If Obamacare turns out, as now seems likely, to be a clear and massive failure, what will come out of its collapse?

There is nothing economically mysterious about health care — it is just another service. Like any other it can be plentifully provided on a free market at affordable prices and constantly improving quality. But like everything else, it breaks down when the central planners get their hands on it, which they now have. To claim that the problems are due to a “market failure” in health care is like saying that there was a market failure in Soviet bread production.